Drug-resistant depression ...

Discussion in 'Et Cetera, Et Cetera' started by Nelly Gay, Dec 1, 2006.

  1. Nelly Gay

    Nelly Gay New Member

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    Has anyone any experience of the above condition where no anti-depressant tablets or treatments seem to lift or alleviate he depression ?
    The side effects of most anti-depressants seem to far outway any positive benefits gained ....
    My current medic seems to feel it is all my fault for not reacting well to treatment and mentioned "NHS resources being scarce" and wondering about the efficacy of further treatments !
     
  2. B_NineInchCock_160IQ

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    Well I've been depressed before but I always felt as though I had good reason to be. If your depression stems from something other than a chemical "imbalance" in your brain then drugs may prove minimally effective.

    In general I think most medications are very over-prescribed, I resist the idea of normalizing everyone so that our personalties fall within more socially acceptable and generally pleasant parameters, and I believe in people's self-determination to effect meaningful change in their own lives without the use of drugs. Like my friend Mike once put it, if we depend on drugs to make us act the way we think we should, we've essentially reduced ourselves to ants... reacting mindlessly to the chemicals secreted by the hive queen's anus, informing the drones of what they should be doing at any given time.

    I do believe there are some people out there who need medication to be able to function. With 3 aunt/uncles with paranoid delusional shizophrenia, one with multiple personality disorder, a few who are bipolar/manic depressive, and several with OCD among other issues... trust me... I understand. I'm no Scientologist. But I still believe the drugs are overprescribed. If you feel you're able to tackle problems on your own without use of drugs, I say go for it.
     
  3. BigA

    BigA New Member

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    Yes, I've been on several anti-depressants. I haven't found them to be effective
     
  4. DC_DEEP

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    NG, depression is so misunderstood by so many people, even doctors, that treatment is usually very difficult. Underlying causes are incredibly variable, exacerbating and mitigating factors have to be considered, treatment options should be carefully tailored to each individual patient, length of treatment/response time are often dismissed...

    If you have one appointment with a physician, tell him you are depressed, and he simply writes out a prescription for medication and says "get this filled, take on tablet twice a day..." then he is not the right doctor. He should ask lots of questions, and you should answer them all, HONESTLY. He should then outline a treatment plan.

    While I understand that the side effects can be pretty nasty, none of the medications works quickly, and it is more than likely that the first medication tried will not work. Generally (not always, but generally) many of the side effects will fade as the body becomes accustomed to the drug, in 3 to 6 weeks. The theraputic effects of the drug usually will not be noticed for 6 weeks to 6 months. So, realistically speaking, if you have to try 4 medications to find the right one, that process could take a year or more.

    Medication is not always the best first line of defense, either. Adjunct therapies often make the medication therapies much more effective, and can sometimes be effective on their own, without drugs.

    The most important thing, though, is to find the main underlying cause of the depression. As NIC mentioned, if the underlying cause is environmental rather than imbalanced brain chemistry, all the medications in the world will not help.

    Please do some online research for treatment options in your area. Best of luck to you, and don't give up.
     
  5. naughty

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    Hi,

    This is a great time of year to bring this topic up. So many people either suffer from SAD (Seasonal Affective Disorder) or are brought down by the hype of the season. I was reading Mehmet Oz's book "You on a Diet" It was fascinating how intertwined our mental health is with the rest of our body. He believes that one of the main reasons people get fat is that their brain is not receiving enough of any one of the hormones that affect mood and is attempting to self correct by causing cravings for fat producing foods. Having suffered from Dysthemia I can say a big AMEN to that. I think one of the problems is that people misuse the term "depression" It is a physical disorder manifested in emotional ways. It can be exacerbated by circumstance, but there is a reason one person can get themselves together after a disappointing experience while another goes into a total tailspin. ALso one medication as DC Deep mentioned does not do for all. So NG, realize that you are not alone. Many people do not know who to go to when they are in need of the right fix. I am coming to the conclusion that the best option is to see a psychiatrist. They are medical doctors who are trained in brain disorders and are much more in tuned with what prescription may be best for you. Having had to serve as a bouncing ball between my psychologist and my internist. I think a psychiatrist may be the best fit. Also , do you homework. I was just telling a friend who has the same two doctor problem to "Google" the various meds, print out information and give it to the doctor. Perhaps you may want to talk to the doctor about Cymbalta which is said to treat the entire body which makes sense on so many levels. So, good luck and know you have an army of support here on LPSG.
     
  6. snoozan

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    NIC, I agree with you in principle-- I don't think GPs should be handing out antidepressants like candy every time someone has a feeling they don't like. I also know that antidepressants do cause some people to be "flat"-- where their emotions sort of flatline. I've had this happen and it's awful-- some people may not mind it, but most I've met do. Anti-depressants don't change your personality or how you think about the world. They just make constant, unremitting mental pain a little less so you can deal with it better. And you're right, they don't work perfectly or for everyone.

    In my case, I need my meds. I was diagnosed with depression as a teenager and now carry a bipolar diagnosis. I take a mood stabilizer that works for depression every day. Depression is not a trend of the hive brain. Depression is real and crippling for many people. I need my meds. There are many people out there that truly do have serious mental illness, which is something a good doctor would be able to discern from a situational or mild depression that is best treated with therapy. This is why I always suggest that before you start on medication, you get referred to a psychiatrist (or good therapist), not just you general practitioner. They are better able to make a call on the medication front.

    To the OP, there are a lot of options for treatment-resistant depression that are not the first line antidepressants that most docs use. There are also adjunct treatments to antidepressants that can raise their efficacy. There is also ECT (electroconvulsive therapy) which has come a long way since the scary days of the 50s and is extremely effective for many people. Kitty Dukakis (the wife of Michael Dukakis) has been getting ECT treatments for years and finds them, on the whole, to be more effective and more tolerable than any of the drugs. She may have written a book recently about it, I'm not sure.

    There is some very good information out there on the web. Two places to start are:

    CrazyBoards (Powered by Invision Power Board)
    Crazy Meds! The Good, The Bad & The Funny of Neurological Medications

    Something that NIC and DC touched on is that not all depression is going to respond 100% to meds (or at all) if you're fundamentally living a life that is hurting you emotionally. This means any drug or alcohol abuse, and even recreational use for some of us. Living in toxic home situations, bad relationships, etc. can contribute to depression, and if nor addressed, will cause the same problems over and over again that will not go away simply because you're taking medication.

    Finally, treatment resistant depression is common. You just have to be very patient. It took me a long time to get on the correct dosage of the correct medication.

    Take care.

    Snooz
     
  7. DC_DEEP

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    Nelly Gay, there are some excellent posts here. Thank you, snoozan, for your input.

    Primary care physicians in particular, and medical doctors in general, are not experts in pharmaceutics and pharmacology. I don't mean that to be an indictment of GPs; they specialize in other areas. No one practitioner can be expected to be an expert in all areas.

    My clinical depression episodes have all been based in dealing with chronic pain - intractable headaches. Some treatments have worked, some have not, some have caused more problems than they solved. You just have to keep yourself informed, and be actively involved in your treatment.

    A lot of the misconception about depression meds is that you take a pill, you feel happy. Antidepressants do not work the same way as, say, sleeping pills - take one, and in 2 hours, it takes effect. The goal of antidepressant drugs is to alter, and stabilize, brain chemistry. It does take time, and since it is such a delicate balance, no one antidepressant has the same exact effect on any one individual.
     
  8. Lex

    Lex
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    The best combination I have seen has been proper diet/exercise, medication (if there is a chemical imbalance) and therapy/self-improvement.

    The medications don't make you happy, they simply make you AVAILABLE to do the personal work on yourself needed to break out of the slump (and avoid future slumps). Finding the right med for you, as DC and others have put it, is key.

    LexaPro (how funny is that name?) worked for me but made me gain weight (like 15 pounds in 2-3 months). We added Wellbutrin XL to help stabalize weight gain (the different chemical composition of the Wellbutrin XL would not work on my mood as my doctor noted) until I could really get in the gym and tweak my eating. Doctors ofetn give Wellbutrin to ex-smokers to curb appetitie.

    Now after improving lots of things about myself, I no longer take the Wellbutrin XL and I only take a 1/2 pill of LexaPro (5 mg) instead of 15-10mg (three years ago).

    And I feel great!

    Good luck, Nelly.
     
  9. joyboytoy79

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    NG,

    Depression sucks! I know from first-hand experience. One of the worst things for me, on my road to recovery, was the hit-and-miss "experimentation" with all the psychotropics. I had some really lousy experiences with doctors, and they put me on some really innapropriate drugs. I'm unlucky that i have a secondary diagnosis of insomnia that seems to be independant of the depression... something some of my doctors have not understood.

    Even with a great doctor, and good meds, it is still a constant struggle for me. I have to consciously think about my mood... something most people don't do. I've learned, through many many many hours of therapy, to think to myself "I feel pretty lousy, don't i? Well, what could be causing that? Have I had enough to eat? Did i get any sleep last night? Is there some stressfull situation i've been avoiding?" In fact, at one point i sat down with my therapist and made a check-list of things that could be bringing me down. Most people, just instincively know what has them down... but because of a medical condition, i don't... i have to really think about it. And it's tough.

    The road to recovery is long and bumpy. If your doctor is focused on only treating you with drugs, find a new doctor. For the vast majority of depression sufferers, drugs alone will not work.
     
  10. snoozan

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    Your forgot, "Is it because I'm living with a crazy nutcase and her family?" Or, "Do I feel bad because she's dragging me all over the universe AGAIN for a photo shoot?"

    :biggrin1::biggrin1::tongue::biggrin1::biggrin1::tongue::biggrin1::biggrin1:

    Something that I notice a lot when people talk about depression is that most people don't understand the difference between feeling bad, being in a bad situation, being stuck in a rut, etc. and clinical depression. Everyone has periods in their lives that are lackluster and sucky. Not everyone is clinically depressed during these times. Sure, they don't feel great, but that is within the normal range of emotions. Clinical depression is something that is long-standing and debilitating. A lot of times when people say, "I'm depressed" or "I feel depressed" they don't really know what depression is. Many doctors don't know this distinction either. My point is twofold: one, the word depression had become a catch-all phrase for various bad emotions and situations for the general public when really it's a specific clinical diagnosis, and two, it really takes a professional well-versed in dealing with mental illness to make the call on whether someone is depressed or not and what the appropriate options are.

    One other thing-- many people with med-resistant depression find some relief in cognitive behavioral therapy (CBT) when used along with medication, diet/exercise, and other good "mental hygeine" practices (which include sleep, relaxation, outlets, social support, etc.) There are a lot of books out there on CBT, the most famous being "Feeling Good" by David Burns. There are also many therapists out there that practice CBT.
     
  11. dreamer20

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    What is OCD?:confused:
     
  12. B_NineInchCock_160IQ

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    Obsessive Compulsive Disorder
     
  13. SpeedoGuy

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    Man, I've had my bouts with depresssion. This time of year is the worst. Oregon's winter weather is not severe but it is dank, dark and gloomy.

    What helps me is regular excercise and all-band light exposure.
     
  14. baseball99

    baseball99 New Member

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    I agree, find a doctor willing to work with you and has experience treating depression. I dont know how it works in socialized health systems with switching doctors, etc so it might be difficult for you.

    Another reason I would never support socialized medicine in the states.....I wouldnt have the heart to stop medications on chronic patients because the resources could be better utilized elsewhere.....which is similar to what you're experiencing
     
  15. Nelly Gay

    Nelly Gay New Member

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    I went to the Priory at £250 an hour , was switched to the NHS and waited a month for a consultation with a Professor in psychiatry (a research professor more suited to academia than patient care?).
    I could switch Psychiatrists but would be happier out-with the whole medical scenario.
    Previously, I had not seen a psychiatrist for 23 years so do not consider myself to be a "drain on scarce NHS resources).
    I wonder if diabetics undergrow this "questioning" about money .
    Interestingly enough my little Priory man was very keen on cash-in-hand and less keen to invoice !
     
  16. BigA

    BigA New Member

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    Yes, I am now being weaned off Effexor. We're giving up i guess. He won't give me Klonopin (sp?) because he says it's a pill form of alcohol. what a bitch
     
  17. baseball99

    baseball99 New Member

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    Not really but in all honesty Type 2 Diabetics should.....for the very reason that the vast majority have caused diabetes or insulin resistance because of their diet, lack of exercise, sedentary lifestyle, etc.....They are at an much much much higher increased risk of heart attacks, stroke, coronary artery disease, peripheral arterial disease, aneurysms and much more. Not only do they accumulate massive hospital bills when they have these problems but they require expensive procedures much more commonly than the average person who isnt type 2 diabetic like coronary artery bypass grafts, angiograms, amputations, 2D echos, stress tests, increased ER visits, etc

    Type 2 diabetes is the ultimate display of the lack of responsibility our world is coming to. 85-90% of all type 2 diabetics is directly related to and correlated with weight and their insulin resistance comes under control when they lose 10% of their body weight and can even basically go away if they lose enough.

    Sorry for the rant

    And also, I dont know how it works in england with reimbursmants but of course the doctor accepted cash in hand. Think about it, nothing works, you used up "your share" and now he wont get reimbursed for anything else he does. Doctors are human and they do have empathy, however, there is nothign wrong with a doctor wanting payment for services. Again, I know nothing about englands system but i know here in the states, in some primary care fields, doctors dont receive payment from anywhere in 10-20% of the patients they see or services they perform in the best interest of the patient.....thats a lot of money
     
  18. Nelly Gay

    Nelly Gay New Member

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    Most illnesses are to a degree "self-inflicted" whether cancer, obesity, diabetes, heart disease, etc etc.
    I have never known sufferers from the so-called physical ailments to be interrogated about the cost of their illness on the hard-pressed NHS system and their accountability though.
    I am happy to pay £250 pounds but NOT when I am quoted £150 and he doesn't accept credit cards and cheques ! The same would apply to a plumber or gardener .
    Most medics in Harley Street are only too happy to invoice ....
    Perhaps my psychiatrist ought to rigorously question "health tourists" who cost the NHS many millions a year ?
    But that would be racist ..... and a whole new issue (and one certainly worth discussing) !
     
  19. B_NineInchCock_160IQ

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    is it really necessary to type in big bold font?
     
  20. baseball99

    baseball99 New Member

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    Yeh i agree many many diseases could be prevented with health and lifestyle choices.....some cancers to an extent (mainly the ones that are increased with smoking, diet, sex, etc) however there are other ones that are really genetic and people have a genetic predisposition for them

    Again, I dont know anything about england, but im sure the "health tourists" are similar to what we see in the states.....it amazes me how many people were "just here on vacation" and suddenly have chronic illnesses that need immediate attention
     
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